Phaze Counseling Services Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

PHAZE COUNSELING SERVICES INC

Practice address

8007 Corporate Dr Ste a
Nottingham, MD 21236-4905

Phone

(410) 874-9595

NPI assigned

Nov 13, 2023

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Shanntel Monique GladneyNPI 1821437559

Title

Ceo

Phone

(443) 622-8755

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Enrollment records 1

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Phaze Counseling Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Nottingham, MD
  • NPI 1447861174

  O20210416000011

  Same enrollment

Tax ID family

Phaze Counseling Serv Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Phaze Counseling Services Inc

  • Rehabilitation Clinic/Center
  • Nottingham, MD
  • NPI 1427669159
  NPD tax ID
• Phaze Counseling Services Inc

  • Rehabilitation Clinic/Center
  • Nottingham, MD
  • NPI 1629842141
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shanntel Monique Gladney, LCPC

  • Professional Counselor
  • Nottingham, MD
  • NPI 1821437559
  NPD (past) Authorized official
• Cureema K Uzzell

  • Clinical Social Worker
  • Nottingham, MD
  • NPI 1982563284
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1699833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699833600000",
    "number": "1174397939",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8007 CORPORATE DR STE A",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8007 CORPORATE DR STE A",
            "city": "NOTTINGHAM",
            "state": "MD",
            "postal_code": "212364905",
            "telephone_number": "410-874-9595"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHAZE COUNSELING SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-13",
        "last_updated": "2023-11-13",
        "certification_date": "2023-11-13",
        "status": "A",
        "authorized_official_last_name": "GLADNEY",
        "authorized_official_first_name": "SHANNTEL",
        "authorized_official_middle_name": "MONIQUE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "443-622-8755"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peak Wellness Therapeutic Services
• Latoya Peggott, FNP-C
• Kristin Lynn Pennewill, MA, BCBA
• Perry Hall Dental Care, P.C.
• Loredana Petrucci, PH.D
• Phaze Counseling Services Inc
• Phaze Counseling Services Inc
• Phaze Counseling Services Inc
• Alicia Phillips
• Paul Ernest Phillips III, D.D.S.

• Community/Behavioral Health Agency in Nottingham, MD
• Providers in Nottingham, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.